The footsteps in the attic. The fin beneath the surface. The shape in the bushes. The light in the cellar.

Real or imagined, these are the things that scare us. That keep us from going up those stairs, or into the water, or to check on the sound outside.

These are also the things behind great horror fiction and movies -- more than sawed-off limbs and splattering blood and randomly slashing maniacs. These are the things that mess with our minds.

"What's scariest? When you don't see the monster, that's what's scariest," says Stuart Fischoff, senior editor of the Journal of Media Psychology, emeritus professor of media psychology at California State University, Los Angeles, and author of many articles on the psychology of horror films.

Or, as Cleveland author Dan Chaon, one of the era's top practitioners of psychological horror, says: "Our imaginations are so active that, in some ways, suggestion has a scarier effect. We picture it in our minds, and it's scarier that way. Blood-and-gore films just feel like going to a butcher shop.

"The things that are the scariest are those you're pondering over at night."

Chaon, whose 2012 collection of short stories, "Stay Awake," is a masterstroke of psychological suspense, penned the afterword for a reissue of what many regard as the finest novel of psychological horror, Thomas Tryon's "The Other."

Tryon's 1971 classic features twins, one good and one very bad, in a small New England town in the 1930s. Mysterious accidents and deaths seem to follow the boys, and Tryon's tricky narrative builds tension as events are seen through the eyes of the "good" twin, Niles. An opaque forewordwritten by someone in a mental hospital sets the foreboding tone.

The novel earned raves when first published, and it continues to impress -- and scare. Said the Chicago Tribune in a typical review, "It is perhaps unfair and a little inaccurate to typecast 'The Other' as a horror story. It is so ingenious and well-written that it transcends that -- or any -- label."

"The roots are as old as Cain and Abel and as fresh as the headlines we can't stop consuming," said Chaon of the book's appeal, in an interview from his Cleveland Heights home.

Chaon adds that horror as a genre taps into emotions in a way other art forms cannot.

"We're fascinated by the darker side of human nature. Even if we're completely normal people, we still have dark thoughts."

Says psychologist Fischoff: "People like to be scared and frightened. It's an extraordinary experience -- if you're doing it right. A lot of films made today are not really that scary. A truly scary film is outside the realm of ordinary experience."

"The Other," which spawned a 1972 film of the same title, shares a common theme with the best psychological horror: the exploration of the psyche. As in, are these characters descending into madness? Or is there really something supernatural going on? Something beyond our human understanding?

Films such as 1968's "Rosemary's Baby" and 1973's "The Exorcist" walked the line between insanity and the supernatural, with characters who were as in the dark as the audience about what was happening.

"Psychological films like these really get under your skin, sometimes in a subconscious way," says Jeon Francis, a classic-horror-film devotee in the Clevelandarea. "You might not realize it at the moment, but then after you watch it, you begin to hear the creaks in your house and see the shadows. . . . It twists your mind."

Human struggle at core of best films

Even when psychological-horror films do delve deep into the supernatural realm, the best ones retain their humanity as well. Evil takes a true toll on flesh-and-blood humans, who often struggle against forces beyond their control. Readers or viewers can relate to their struggle -- and perhaps even see themselves in the protagonists -- thus making the toll, and the scares, all the more forceful.

In Stephen King's classic 1975 vampire tome " 'Salem's Lot," for example, the battle against the resident vampire is given emotional heft by the valiant, often fruitless, battle waged against him by writer Ben Mears.

In this season's hot vampire epic, Justin Cronin's "The Twelve," released earlier this month, the scares are all the more brutal because these vampires/virals were man-made in a twisted government experiment. And in the novel's post-apocalyptic future, some of the biggest horrors come from the humans, not the brainless flesh-eaters.

"Humans are more manipulative [in my novel]; the virals aren't playing a mind game," Cronin said in a recent phone interview. "I always intended [for the humans to be more terrifying than the virals].

"The greatest evils we've seen in the history of civilization have been in societies like 'The Homeland' in my story. One of the most pressing questions people had to wrestle with after World War II was how presumably good, ordinary people can be drawn into complicity" with evil.

Evil within the realm of the seemingly ordinary can be the scariest thing of all, agrees psychologist Fischoff.

"The closer to reality something is, the scarier it is. What people like [director] Wes Craven do is validate that the world is indeed a very scary place. You don't need monsters to be done in -- it can be the third house on the left that's gonna get you."

Why 'Jaws' stays with you for life

He cites another very famous example of a film that still terrifies moviegoers 37 years after it came out: Steven Spielberg's "Jaws."

"A story like 'Jaws' has the potential to stay with you for the rest of your life. What 'Jaws' did was take horror and put it onto the mundane reality of daily life."

Dave Huffman, director of marketing for Cleveland Cinemas, who programs the Capitol Theatre's annual "12 Hours of Terror" marathon and is something of a horror aficionado, says "Jaws" remains "one of the scariest movies ever made."

"What's more terrifying than the first scene when the woman is pulled down into the ocean? What you imagine is terrifying," he explains.

Spielberg's technique with "Jaws" -- in which the shark was hinted at but not seen until more than 90 minutes into the movie -- is a textbook example of how to manipulate the physiology of fear, says Fischoff.

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"Clearly, those films which build up a lot of tension and draw upon the imagination of the viewer instead of making everything explicit are the scariest. The gradual buildup of tension and fear makes the fear experienced greater than if it had not been building up to that point.

"The physiology takes your body and begins to push buttons, for a gradual arousal. A Hitchcock-style movie does this -- it builds on anxiety and fear incrementally, and you bring your own residue of fear already in your system. 'The Blair Witch Project' actually made people sick because of this."

"Blair Witch," is, of course, an extreme example.

Most horror films, says Fischoff, are a "way to have a safe experience of an extreme situation. It only becomes a problem when it lingers with you -- that's not what people want."

Just ask Huffman, who thinks of "Jaws" whenever he sees the ocean and credits some sleepless nights to a newer horror franchise.

"I think the 'Paranormal Activity' movies are very scary," he says of the "found footage" ghost flicks.

"After seeing the first two, I really had a hard time sleeping. These films freak you out and fool with your head."

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